The NCCTG Gastrointestinal (GI) Cancer Program brings together specialists from all oncology disciplines with the following goals: 1. To improve cure rates when possible or extend survival/improve patient quality of life. a) Initiation/leadership of GI Intergroup/NCCTG phase III clinical trials. b) Participation in GI Intergroup trials led by other oncology groups. c) Rapid initiation/completion of Pilot Studies and Phase II trials, based on the most promising GI cancer treatment strategies developed in the Mayo Clinic Phase I program or elsewhere in collaboration with the NCCTG Novel Therapeutics Committee. This strategy manifests itself in the performance of targeted research studies across the eight primary GI tract sites. d) Integration of multiple modalities (surgery, radiation, and medical oncology) and participation of the appropriate modality committees in trial design and conduct. 2. To devise therapies that an be administered in proximity to the patient's home, with referral to specialized centers when approprite. a) By forging a research-driven partnership between the research and community bases. b) By conducting education symposia based in and around NCCTG meetings. 3) To further the understanding of tumor biology and host response through the investigation of prognostic determinants, factors influencing disease progression, and individual responses to chemotherapy (i.e. translational research). a) Interaction with Mayo Clinic researchers with expertise in correlative science. b) Collaboration with laboratory-based investigators elsewhere. 4. To utilize the extensive NCCTG database in completed studies to answer questions arising in clinical practice, from analyses of prospective trials, or from the literature. 5. To monitor and improve patient quality of life (QOL) and the tools to assess QOL. 6. To advance the field of clinical trials research by design of new trial paradigms and systems for optimal data collection in response to issues arising from our studies. 7. To entice involvement from diverse members of the multi-disciplinary oncology team in collaborations dedicated to extending the horizons of cancer care. This application will focus on the past, present, and projected future of the NCCTG GI Program based upon our accomplishments during the last grant period. We will delineate specific programmatic approaches that define the NCCTG GI Program based on the philosophical principles noted above. We will concentrate on our accomplishments in the prior grant period (present), and project the themes and outline the new initiatives that we hope will define our program in the next grant period (future).